zlacker

>>wallfl+(OP)
Healthcare in the US is broken and they won’t let you fix it because the money is too good. Think about the fact that PBMs, which is there to save and manage on pharma is incentivized to promote drug price inflation. That’s just one “small” piece of this clusterf*k. It’s layers and layers of these convoluted system of incentives.

As to OP, the simplest solution is to move out of the US early enough or become “poor” enough and be in a wealthy blue state by the time you get to this predicament.

>>lvl155+rl
Healthcare is little more than a jobs program at this point.

I believe it is the largest industry by employment in every single state now.

That compounds the problem even further. Really fixing it would put a double digit percentage of people out of work. I'm all for it, but I can see why politicians are hesitant.

>>silisi+lP
> Really fixing it would put a double digit percentage of people out of work. I'm all for it, but I can see why politicians are hesitant.

I'd love to hear what you think "really fixing it" is, please share.

I can report that all (almost all?) of the hospitals and their networks both big and small in the area I am in have had layoffs this year of admin staff and healthcare professionals (nurses, doctors, etc). They have reduced bed counts, and cut programs and treatment options available. All of this was done in the name of the "affordability crisis" and is kind of like the 3rd wave of this kind of consolidation, belt-tightening behavior. And..prices haven't gone down, and they keep cutting.

>>Aviceb+dQ
> I'd love to hear what you think "really fixing it" is, please share.

I'm not that poster, but there's a really easy fix: Just model the system after Hong Kong's.

There's a tax-funded public system available to every citizen, so that everybody gets treatment. In practice, this is mostly utilized by the poor, and for emergencies like broken bones. You can see specialists via the public system, but there can be a wait of weeks to months. This is all effectively free. You'll never see a bill, or the bill will be extremely small. (e.g., $100 for four days of inpatient care.)

There's a private system for those willing to pay. This is unrestrained capitalism with little regulation and no parasitic middlemen. Want to see a specialist right now -- like later this afternoon, or first thing tomorrow morning? Sure. It'll usually be $200 or $300 out of pocket. No insurance necessarily involved. Diagnostics are also super fast -- same day or next day, usually. If you want an elective surgery, or if you want a superior tier of care (like a nicer hospital room, better food, more flexibility re scheduling,) you can pay for it privately... And usually without getting insurance companies involved.

There is effectively no "prescription" system. With very few exceptions for narcotics and certain stimulants, if you need a drug of any kind, you can buy it OTC. This includes steroids, weird nootropics, viagra (lol at needing a prescription for this), and all kinds of stuff. This vastly reduces the burden on the system.

Hong Kong's system is superior in every respect, and it's especially better at treating you like an adult. The American system is simultaneously complex and infantilizing.

>>A_D_E_+x61
Aside from the prescription part, this is exactly 1:1 how it works in the US. I say this having myself and my family utilize all of it extensively, public tax-funded emergency treatment, inpatient coverage, private doctors and specialists.

>>llbbdd+C91
The public system in Hong Kong doesn't really cost anything. It's not that you get costs "waived" if you whine hard enough that you ought to be a charity case (which, by the way, is degrading,) and it's not that costs are passed on to a middleman. Medical treatment is transparently priced and simply inexpensive -- so it's simply not a cause of bankruptcy in Hong Kong, whereas, in the US...

> https://worldpopulationreview.com/country-rankings/medical-b...

Also, perhaps because it's a lot more laissez faire, the private system in Hong Kong is almost unimaginably superior to the private system in the US. It's far cheaper because pricing is transparent and most people pay cash! (Cutting out that middleman.) It's higher quality because there's a lot more competition, rather than collusion among a few major providers.

>>A_D_E_+Pd1
Nearly identical with a coat of paint. Every "horror story" I've heard about having to beg with the health system here is tellingly parroted by people who do not have experience with the system. It is the default to get itemized bills when you are insured and the outcome is the same. And again, there is nothing unusual about private care in the US - I pay cash, direct, a small amount monthly, for excellent private care. The ghost people claim to haunt US healthcare is mostly propaganda that for some reason is consumed wholesale by people outside the US who have no stake in it.

>>llbbdd+3x1
You are completely wrong, and I can almost hear in my mind how you think something you are promoting as true, is 'basically true' - but please know there are plenty of people reading HN from afar and may come to expect 'free healthcare in US (just go to the ER!)' from your comments.

No it is not.

Lots of experience with the health system in the US, for me, and helping many other navigate the systems.

It's not even close to identical. If you go to ER here and you can't pay, they may provide you with a certain level of 'care' to 'stabilize you' (as the law says they are supposed to, and the feds send some money to hospitals to cover some of this), and you will get billed, and collections calling, and credit report issues, and threats to sue and have your property auctioned (have held one of these letters in my hand, complete with a list of property that was in my name.

Even worse, the 'care' you may get is normally crap. For example I have seen the same people with same condition, at one hospital get a quick surgery and leave with a colostomy bag for rest of life, and other person at other hospital with insurance get placed in a room and treated for weeks - then left with a warning to avoid seeds.

I have seen so many examples of places leaves humans to rot with no insurance - hospitals.

Even with insurance, you can find yourself waiting 6-8 weeks for a doc appointment. I have so many examples.